Publications by authors named "Eric Ohuma"

Background: Joint models are powerful statistical models that allow us to define a joint likelihood for quantifying the association between two or more outcomes. Joint modelling has been shown to reduce bias in parameter estimates, increase the efficiency of statistical inference by incorporating the correlation between measurements, and allow borrowing of information in cases where data is missing for variables of interest. Most joint modelling methods and applications involve time-to-event data.

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Background: The Every Newborn Action Plan (ENAP) indicators are essential in monitoring neonatal healthcare coverage and quality. The District Health Information System (DHIS2), an open-source platform in over 80 countries, supports health data collection and analysis, enabling progress tracking at national and subnational levels. This study evaluates the availability and quality of maternal and newborn health indicators, explicitly focusing on ENAP indicators within Tanzania's DHIS2.

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Background: Accurate growth assessment of preterm infants is essential in guiding medical care and suitable nutritional interventions. Currently, different growth references are used across hospitals in the United Arab Emirates (UAE). This study aims to compare the INTERGROWTH-21st standards with Fenton growth references regarding birth size classification and at the time of discharge in a sample of preterm infants in the UAE.

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Introduction: Application of data science in maternal, newborn, and child health (MNCH) across Africa is variable with limited documentation. Despite efforts to reduce preventable MNCH morbidity and mortality, progress remains slow. Accurate data are crucial for holding countries accountable for tracking progress towards achieving the Sustainable Development Goal 3 targets on MNCH.

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Article Synopsis
  • Post-term pregnancy, reaching or exceeding 42 weeks of gestation, is linked to negative birth outcomes, and while high-income countries often induce labor, low- and middle-income countries lag behind.
  • The study aims to examine the prevalence of post-term births, associated risk factors, and their connections to small-for-gestational-age (SGA) neonates and infant mortality in middle-income settings like Brazil, Mexico, and Palestinian refugees.
  • Analyzing over 45 million live births, the research found that post-term deliveries significantly increased the risk of SGA neonates and infant mortality, suggesting the need for induction strategies to address these issues.
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Objective: To compare stillbirth rates and risks for small for gestational age (SGA), large for gestational age (LGA) and appropriate for gestational age (AGA) pregnancies at 24-44 completed weeks of gestation using a birth-based and fetuses-at-risk approachs.

Design: Population-based, multi-country study.

Setting: National data systems in 15 high- and middle-income countries.

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Background: The ratio of soluble fms-like tyrosine kinase 1 to placental growth factor is a useful biomarker for preeclampsia. Since it is a measure of placental dysfunction, it could also be a predictor of clinical deterioration and fetal tolerance to intrapartum stress.

Objective: We tested the hypothesis that soluble fms-like tyrosine kinase 1 to placental growth factor ratio predicts time to delivery.

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Background: Household air pollution might lead to fetal growth restriction during pregnancy. We aimed to investigate whether a liquefied petroleum gas (LPG) intervention to reduce personal exposures to household air pollution during pregnancy would alter fetal growth.

Methods: The Household Air Pollution Intervention Network (HAPIN) trial was an open-label randomised controlled trial conducted in ten resource-limited settings across Guatemala, India, Peru, and Rwanda.

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Background: Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets.

Methods: A health facility assessment (HFA) tool was co-designed by Newborn Essential Solutions and Technologies (NEST360) and UNICEF with four African governments.

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Background: Each year an estimated 2.3 million newborns die in the first 28 days of life. Most of these deaths are preventable, and high-quality neonatal care is fundamental for surviving and thriving.

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Background: Low birthweight (LBW; <2500 g) is an important predictor of health outcomes throughout the life course. We aimed to update country, regional, and global estimates of LBW prevalence for 2020, with trends from 2000, to assess progress towards global targets to reduce LBW by 30% by 2030.

Methods: For this systematic analysis, we searched population-based, nationally representative data on LBW from Jan 1, 2000, to Dec 31, 2020.

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Objective: To examine the contribution of preterm birth and size-for-gestational age in stillbirths using six 'newborn types'.

Design: Population-based multi-country analyses.

Setting: Births collected through routine data systems in 13 countries.

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Article Synopsis
  • - The study analyzed data from 115.6 million live births across 15 countries from 2000 to 2020 to assess the prevalence and neonatal mortality rates associated with large for gestational age (LGA) and macrosomia.
  • - Results indicated that LGA babies (those above the 90th percentile) had a lower risk of neonatal mortality compared to appropriate for gestational age (AGA) infants, while overall macrosomia (≥4000 g) also did not show increased mortality risk, except for higher weight categories.
  • - The findings suggest that a birthweight of ≥4500 g is a key indicator for increased early mortality risk in larger infants, which could help inform clinical decisions regarding their care. *
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Background: Thirty million small and sick newborns worldwide require inpatient care each year. Many receive antibiotics for clinically diagnosed infections without blood cultures, the current 'gold standard' for neonatal infection detection. Low neonatal blood culture use hampers appropriate antibiotic use, fuelling antimicrobial resistance (AMR) which threatens newborn survival.

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Background: Every Newborn Action Plan (ENAP) coverage target 4 necessitates national scale-up of Level-2 Small and Sick Newborn Care (SSNC) (with Continuous Positive Airway Pressure (CPAP)) in 80% of districts by 2025. Routine neonatal inpatient data is important for improving quality of care, targeting equity gaps, and enabling data-driven decision-making at individual, district, and national-levels. Existing neonatal inpatient datasets vary in purpose, size, definitions, and collection processes.

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Objective: Low birthweight (<2500 g) and preterm birth (<37 weeks) are markers of newborn vulnerability. To facilitate informed decisions about investments in prevention and care, it is imperative to enhance data quality and use. Hence, the objective of this study is to systematically assess the quality of data concerning low birthweight and preterm births within routine administrative data sources.

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Maturation of the human fetal brain should follow precisely scheduled structural growth and folding of the cerebral cortex for optimal postnatal function. We present a normative digital atlas of fetal brain maturation based on a prospective international cohort of healthy pregnant women, selected using World Health Organization recommendations for growth standards. Their fetuses were accurately dated in the first trimester, with satisfactory growth and neurodevelopment from early pregnancy to 2 years of age.

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Background: Preterm birth is the leading cause of neonatal mortality and is associated with long-term physical, neurodevelopmental, and socioeconomic effects. This study updated national preterm birth rates and trends, plus novel estimates by gestational age subgroups, to inform progress towards global health goals and targets, and aimed to update country, regional, and global estimates of preterm birth for 2020 in addition to trends between 2010 and 2020.

Methods: We systematically searched population-based, nationally representative data on preterm birth from Jan 1, 2010, to Dec 31, 2020 and study data (26 March-14 April, 2021) for countries and areas with no national-level data.

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Background: Anaemia in pregnancy is a global health problem with associated maternal and neonatal morbidity and mortality. We aimed to investigate the association between maternal haemoglobin concentrations during pregnancy and the risk of adverse maternal and neonatal outcomes.

Methods: In this prospective, observational, multinational, INTERBIO-21st fetal study conducted at maternity units in Brazil, Kenya, Pakistan, South Africa, and the UK, we enrolled pregnant women (aged ≥18 years, BMI <35 kg/m, natural conception, and singleton pregnancy) who initiated antenatal care before 14 weeks' gestation.

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Objective: To systematically review and assess the risk of bias in the literature evaluating the performance of INTERGROWTH-21 estimated fetal weight (EFW) standards to predict maternal, fetal and neonatal adverse outcomes.

Methods: Searches were performed in seven electronic databases (Scopus, Web of Science, Medline, Embase, Lilacs, Scielo and Google Scholar) using citation tools and keywords (intergrowth AND (standard OR reference OR formula OR model OR curve); all from 2014 to the last search on April 16, 2021). We included full-text articles investigating the ability of INTERGROWTH-21 EFW standards to predict maternal, fetal or neonatal adverse outcomes in women with a singleton pregnancy who gave birth to infants with no congenital abnormalities.

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Background Reducing low birthweight (LBW, weight at birth less than 2,500g) prevalence by at least 30% between 2012 and 2025 is a target endorsed by the World Health Assembly that can contribute to achieving Sustainable Development Goal 2 (Zero Hunger) by 2030. The 2019 LBW estimates indicated a global prevalence of 14.6% (20.

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Small newborns are vulnerable to mortality and lifelong loss of human capital. Measures of vulnerability previously focused on liveborn low-birthweight (LBW) babies, yet LBW reduction targets are off-track. There are two pathways to LBW, preterm birth and fetal growth restriction (FGR), with the FGR pathway resulting in the baby being small for gestational age (SGA).

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